Rudenko M. Diagnosis and treatment of postinfarction defect of interventricular septum

The dissertation is devoted to the problem of surgical treatment of patients with postinfarction rupture of interventricular septum (PI IVSR). The problem is the first national research in which are generalized the well-known scientific problem and outlined new ways of their solution. Developed the tactics and strategy of surgical treatment of the PI IVSR in order to improve the immediate results, to study the significance of the localization of the VSR and the parameters of intracardiac hemodynamics for the prognosis of the disease. The evaluation of the results of operations on the PI IVSR studied during the course of work allowed to determine the optimal time intervals for operative intervention. In this work, the prognostic significance of the localization of the rupture for the further course of the disease is estimated and proven. In this work, for the first time, morphological and histological changes in the PI region of the IVSR region were investigated and described at different times after the MI. The algorithm of management of patients with PI of IVSR with the account of localization characteristics and severity of the patient's initial state is developed and implemented in practice. A new method of closing the "sandwich" defect is introduced with autopercicard with p-like sutures, which are duplicated: excluding IVSR from the zone of LV, which is under the influence of high pressure. The development and implementation of an advanced algorithm for surgical intervention has allowed to reduce the number of postoperative complications and surpass the world's results.